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Ann Thorac Surg 2007;83:2235-2238
© 2007 The Society of Thoracic Surgeons

How To Do It

Laparoscopic Cardioplasty to Avoid Esophageal Resection in Patient Not Responsive to Heller Myotomy

Gianmattia del Genio, MD*, Alberto del Genio, MD, PhD, Luigi Brusciano, MD, Gianluca Russo, MD, Francesco Pizza, MD, Federica del Genio, MD, PhD, Gianluca Rossetti, MD, PhD

First Division of General and Gastrointestinal Surgery, Second University of Naples, Naples, Italy

Accepted for publication July 10, 2006.

* Address correspondence to Dr del Genio, Via Strettola a Chiaia, 7, Napoli, I-80122, Italy. (Email: gdg{at}doctor.com).

Some achalasia patients do not ameliorate dysphagia after Heller myotomy. If stenosis does not respond to endoscopic dilatations and persists after a second extended myotomy, an esophageal resection is considered unavoidable. This article describes an original technique of treating this type of persistent stenosis with an esophageal stricturoplasty. The procedure was completed under laparoscopy. The postoperative course was uneventful. Resolution of all preoperative symptoms was achieved at the first year follow-up. Control of gastroesophageal reflux was documented by 24-hour pH-impedance. If confirmed by further cases, laparoscopic esophageal stricturoplasty could become a valid option for a conservative treatment of these patients.






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Copyright © 2007 by The Society of Thoracic Surgeons.